MEDICARE: KARLA LOPEZ ABA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor
2	103K00000X	Behavior Analyst
3	106S00000X	Behavior Technician
4	103K00000X	Behavior Analyst	LBA0729	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265862130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLA LOPEZ ABA

Provider Business Mailing Address
First Line	:	5575 SIMMONS ST
Second Line	:	#1-363
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-9009
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2619 W CHARLESTON BLVD STE D
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2121
Country	:	US
Telephone Number	:	725-301-1182
Fax Number	:	702-441-2134

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2013
Last Update Date	:	07/08/2024

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Directions to “ KARLA LOPEZ ABA” Practice Location

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